Individual
NICKEA M TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1464 MULBERRY LN, AVON, OH 44011-4032
(440) 444-8349
Mailing address
1464 MULBERRY LN, AVON, OH 44011-4032
(440) 444-8349
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
501115040506
OH
372500000X
Chore Provider
Primary
501115040506
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307236
—
OH
01
—
CS1928100128
CARE SOURCE
OH
Enumeration date
05/30/2021
Last updated
05/30/2021
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